Recurrence After Operative Treatment of Adhesive Small-Bowel Obstruction

Background Postoperative adhesions are a common cause of small-bowel obstruction, and up to 53% of patients operated on for adhesive small-bowel obstruction (ASBO) experience recurrence. The primary aim of this study was to identify predictors for recurrence of ASBO. Methods We reviewed medical reco...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2018-02, Vol.22 (2), p.329-334
Main Authors: Lorentzen, Lea, Øines, Mari N, Oma, Erling, Jensen, Kristian K, Jorgensen, Lars N
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Gastroenterology
Gastrointestinal surgery
Humans
Intestinal obstruction
Intestinal Obstruction - etiology
Intestinal Obstruction - surgery
Intestine, Small
Male
Medical records
Medicine
Medicine & Public Health
Middle Aged
Original Article
Proportional Hazards Models
Recurrence
Risk Factors
Sex Factors
Small intestine
Surgery
Tissue Adhesions - complications
Tissue Adhesions - surgery
Young Adult
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Summary:Background Postoperative adhesions are a common cause of small-bowel obstruction, and up to 53% of patients operated on for adhesive small-bowel obstruction (ASBO) experience recurrence. The primary aim of this study was to identify predictors for recurrence of ASBO. Methods We reviewed medical records including operation descriptions from patients who underwent emergency surgery due to ASBO at our institution between 2004 and 2013. Information on the peri- and postoperative periods, including conservatively and surgically treated recurrent ASBO, were obtained from medical records. Results In total, 478 patients were included in the study. Of these, 58 (12.1%) patients experienced recurrence of ASBO during median 2.2 years follow-up. Female gender (hazard ratio [HR] 2.00, P  = 0.023), multiple/matted adhesions (HR 1.72, P  = 0.046), and fascial dehiscence (HR 3.26, P  = 0.009) were associated with increased risk of recurrence. Conversely, intestinal resection decreased the risk of recurrence (HR 0.47, P  = 0.036). Conclusions The overall recurrence rate after surgically treated ASBO was 12.1%, and the risk of recurrence was persistent several years after index operation. Factors associated with an increased risk were female gender, multiple/matted adhesions, and fascial dehiscence.
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-017-3604-x